Research report health tourism


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Research report health tourism

  1. 1. Research Report 31 May 2012 On Health Tourism in Himachal PradeshSubmitted To: Submitted By:Prof. S. P. Bansal Naveen VermaDirector MTA 4th SamIVS, MTA, H. P. University Exam No: 1579 Roll No: 443 2012 Institute of Vocational (Tourism) Studies Masters of Tourism Administration Himachal Pradesh University Summer hill, Shimla- 171005
  2. 2. ACKNOWLEDGEMENT First of all I am thankful to almighty God for his divine bless ingand love. Its my pleasure to acknowledge indebtedness and heartfelt thanks toProf. (Dr.) S .P. BANSAL, Director (M.T.A), Institute Of VocationalStudies, for his great effort to make us experience and work-on for areport on : “HEALTH TOURISM IN HIMACHAL PRADESH”I would also like to mention the invaluable support of our respectableteachers:Dr. Chander Mohan, Dr. Shushma Rewal Chug, for there great guidanceand favorable support. I would also like to thanks other teachers Dr. JaswinderSharma of the department who helped me during the preparation of thisresearch.Date: 31/05/12 Naveen VermaPlace: HPU - Shimla 2
  3. 3. ContentsS. No. Particulars Page No. a Acknowledgement 2 b Contents 3 c Preface 4 Part – I Health Tourism 1 Introduction to Health tourism 6 2 Concept of Healthy Living and Healthy Lifestyle 7 3 What We Can Do for a Healthy Living 7 4 Health Spas and Massage - Health Tourism 23 5 India Health Spas 25 6 Types of Massages for Health Tourism 27 7 Medical Tourism as a part of Health Tourism 42 8 Risks of Medical Tourism 44 9 Benefits of Medical Tourism 45 10 Medical Tourism in India 47 11 Alternative Medicine Treatments 48 12 Alternative Medicine treatments in India 65 13 Health Tourism in India 66 14 Ayurveda & Health Tourism 68 15 Herbal Medicine & Health Tourism 69 16 Yoga & Health Tourism 70 17 Meditation, Meditation Retreats & Health Tourism 71 Part – II Case Study / Research 18 Research Design 73 19 Research Methodology 75 20 Case Study in Health Tourism 81 21 Designing the Health Product 90 22 Developing and Positioning of Health Tourism Product 93 23 Major players in Health Tourism 95 24 Survey 99 Part – III Health Tourism in Himachal Pradesh 25 About Himachal Pradesh 111 26 Health Tourism in Himachal Pradesh 114 27 A Case study on a Health Project in Himachal Pradesh 118 28 Health Tourism in Himachal Pradesh – SWOT Analysis 120 29 Resources available at Himachal Pradesh for Tourism 121 30 Recommendations 122 31 Conclusions 127 32 Questionnaire Format 128 33 References 131 3
  4. 4. PrefaceFor centuries health has been one of the main motivations for travel. Travelling for achange of weather so as to improve or to rebuild ones’ strength/health has always existed. History traces it long back, though special places or destination for building healthcan be positively established since Roman era. The Roman Empire constructed ‘baths’popularly known as ‘spas’ where various health-related services like massage, sauna, etc.were provided to visitors. Ordinarily, these spas were believed to be the resting place ofdivine nymph and it was believed that when a visitor used to take a dip in the holy waterbelieved to have developed symbolic relationship with them. Later on, a city ‘Bath’ inEngland became very famous as a destination for health tourists. This city boasted ofbaths either built by Romans or constructed on the lines of Roman baths. In modernworld, health has become very precious. Feeling and looking healthy seems to be themantra for today’s fast moving generation. Consequently, many health related travelservices have come up who looks after both the physical and spiritual well being of thetour package buyer. The customer/buyer/client/traveller has the choice of picking toursfrom various spas, health clubs, ayurvedic, yoga and spiritual centres. These are gainingpopularity among corporate traveller who spends quite a lot of time away from home onbusiness trips.This report is divided into three parts, Part I, II & III.In Part – I, prime focus is upon the concept of health and health tourism. I have tried todescribe various forms/activities of health sector and its link to tourism along with therecurrent status in India.In Part – II, with the help of small case study, I have tried to define and describe thevarious forms of Health Tourism, design and develop a health tourism product, andcomprehend the future scope and prospect of health tourism.In Part – III, I have tried to express Himachal as a Health tourism destination, along withconclusion and recommendations. 4
  5. 5. Part – IIntroduction to Health Tourism 5
  6. 6. 1. INTRODUCTIONDefinition of Health TourismHealth tourism or medical tourism is a particular process of traveling different parts of theworld to avail advanced Health & Medical care other treatment by highly experienced aswell as professional surgeons at any of the advanced and state-of-the-art medicalinstitutes of the world. Health tourism can be described in various ways that are alsoknown as health travel, medical travel, medical value travel, medical overseas, surgeryoverseas, medical outsourcing, health care abroad, offshore medical and many more. As more people around the world take an active interest in their health, a travelsegment known as health tourism has evolved to fill customer needs. Not to be confusedwith medical tourism, which focuses more on surgical procedures, health tourism is amuch broader concept which include medical but primarily centered around resortsdesigned to pamper or improve the body and relax the mind. Hundreds of health resorts and spas exist around the world, offering specializedbeauty and fitness services, and extended programs to improve your health. These resortsare almost always located in stunning natural environments or in the trendiest citydistricts. Spas play a major role in health tourism, but this field also extends into areaslike addiction treatment and weight loss. Destination spas and health resorts are the most common and popular health travelvenue. They offer a comprehensive range of services, from massage and Ayurvedictherapy to yoga and outdoor recreation facilities. The goal of these resorts is to sendtheir guests home feeling happier, healthier, fitter and more relaxed. Everything iscontained within the health spa resort, allowing guests to relax and focus on themselves. Spa resorts often specialize in a particular health remedies. Mineral baths havebeen around for thousands of years, and countries like Bulgaria and New Zealandcapitalize on these natural geothermal properties. Mud baths and other natural health 6
  7. 7. cures are usually accompanied by a full menu of pampering services like massage andfacials at these facilities. More holistic resorts offer treatments like acupuncture, coloniccleansing, hypnotherapy and meditation. There are also specialized health centers for issues such as weight loss. Theseresorts place an emphasis on losing weight and improving eating habits. Guests typicallyfollow a schedule lasting from a few days to a week or more. The meals are speciallytailored to boost health and guests attend workshops to learn more about staying fit,eating right and keeping their weight down. Another common specialized health destination is for addicts. Alcohol and drugaddiction are the two most common problems dealt with at these facilities. They are setup like all-inclusive resort centers, except that there is more emphasis on monitoring theguests’ behavior and keeping them on their rigid programs. These are not particularlyrelaxing resorts, but they can often break a person’s addiction in a healthy manner. Fitness holidays are gaining popularity with travelers who want to get some well-needed exercise while on vacation. This is the broadest category of health tourism,because the location is more important than the venue. Mountain resorts provide skiingin the winter and hiking and biking in the summer. Beach resorts are also popular forswimming and water sports. A fitness holiday places the impetus of action entirely on thetraveler, and there are resorts at virtually every popular outdoor destination on the planet. 7
  8. 8. 2. Concept of Healthy Living and Healthy Lifestyle Before discussing about Health Tourism, it should be clear to one about theconcept of Health. There are many factors that affect our health. While some cannot becontrol (such as genetics and age), there are many other factors that are under yourcontrol. Not only will leading a healthy lifestyle improve our health, wellbeing andhappiness, studies have also shown that some of the leading causes of death such as heartdisease, stroke, cancer and other serious diseases can be prevented by improving personalhealth habits. A healthy lifestyle can also reduce recovery times, make a person lookhealthier and younger and provide more energy. Eating right, staying physically active, reducing stress and avoiding or moderatingharmful addictions such as smoking and drinking are the basis of a healthy life.3. What We Can Do for a Healthy Living: Healthy living must take into consideration the needs of the individual sincedespite similarities in our physiology, every human being has unique physicalrequirements that are dependant on factors such as age, weight, physical and mentalactivity and any physiological peculiarities that our bodies develop or are born with. 8
  9. 9. There are, however, general guidelines that the medical community is in agreement onand it’s from these guidelines that tip for living a healthy life can be established. 1. Healthy Diet: Eat a balanced diet including a variety of healthy foods and limit calories and saturated fats. 2. Health Fitness: Be physically active 3. Weight Loss: Maintain a healthy weight 4. Healthy Sleep: All living beings require sleep and regular sleep patterns are considered essential to a healthy human existence. 5. Checkups: See our doctor for regular visits (not just when our are sick) and keep our shots up to date. 6. Blood Pressure: Control our blood pressure and cholesterol 7. Manage Stress: Reduce stress in our life 8. Healthy Skin: Protect ourselves from too much sun - don’t sunbathe or use tanning booths. 9. Stop Smoking: Smoking has no place in a healthy lifestyle. 10. Substance Abuse: Alcohol and stimulants such as caffeine should only be consumed in moderation and narcotics should be avoided at all costs. If we have a problem with alcohol or drugs there are retreats and clinics to help us. 11. Sexual Health: Practice safe sex 12. Women’s Health: For women - check your breasts and get regular Pap smears 9
  10. 10. 3.1 Healthy Living • Blood Pressure Health: For many, blood pressure is not a daily concern. Between waking and sleeping, the strength and speed with which our hearts pump and the resulting impact on our arteries and overall health goes mostly overlooked. However, for close to one billion people around the world with high blood pressure, or hypertension, it is of great importance and something that everyone could stand to pay more attention to. Simply put, blood pressure is the force of our pumping blood pushing against the walls of our arteries. Measuring the blood vessels during a heartbeat and the moment of relaxation in between provides a dual reading known as systolic and diastolic pressure. Statistics reveal that people who have normal blood pressure even into their early 50s still have a 90 percent likelihood of developing high blood pressure in their lifetimes. Affecting nearly 50 million Americans at present, the chance of developing high blood pressure is too large to ignore. High systolic pressure, especially in people over the age of 50, carries a number of significant health risks. Heart disease, stroke, heart failure, heart attack, kidney failure and even death are linked directly to prolonged hypertension. As frightening as that may sound, a confirmation of high blood pressure does not have to be the beginning of the end. Lowering the systolic pressure is necessary and several methods exist to accomplish this and control high blood pressure. In most cases, a number of lifestyle changes are required. Dietary adjustments can be of great benefit in lowering high blood pressure and many health-care providers encourage their patients to increase their daily intake of fruits, vegetables and fiber. Decreasing fatty foods, dairy products, salt and red meats are also counseled. This nutrition program is generally referred to as the DASH plan, meaning Dietary Approaches to Stop Hypertension. 10
  11. 11. Other approaches to healthier living go hand in hand with the DASH plan, such as limiting alcohol consumption and not smoking. Exercise is of obvious benefit and aerobic activity in the form of swimming, walking, jogging or cycling for 30 minutes every other day will not only lead to a more appropriate body weight and lower blood pressure, but will allow any medication required to assist in controlling high pressure to be that much more efficient.• Checkups Also known as health exams, physical examinations or routine physical examinations, checkups can find problems before they start or before they get a foothold, and as we all know, prevention is better than cure. Although many consider the need for having health checkups unnecessary or only for those with advanced years, having regular annual checkups is a good idea for people from the age of 30 years. Those into their 50s who don’t go for regular checkups should have a rethink, as this is the age when diseases may start to set in more frequently, plus the body generally shows signs of wear and tear at an increased rate. The depth of checkups we need will depend on a number of criteria, including our age, our current state of health and our family history, as well as whether we smoke, our level of fitness and even what we eat. Health checkups generally include a weight check, blood pressure check, regular pulse check, vision tests, and a lookout for breast cancer, testicular cancer, prostate cancer, and cholesterol levels, for example. As a preventative measure, doctors will generally advise smokers and drinkers to cut back on their intake, exercise regularly, and try to reduce stress levels. In truth, eating properly and exercising are the two biggest factors for ensuring we give our body the chance of a healthy existence. 11
  12. 12. General practitioners (GPs) generally do health checkups and are the best bet to help us feel more at ease, if we are apprehensive about having a checkup. Family doctors are ideal in this respect. For more thorough checkups, a trip to the hospital will generally be necessary. Regarding self checkups, getting into the habit of analyzing our body whenever in the shower is a good idea for picking up the odd lump or bump. Do this every other day, or perhaps weekly - women checking for unusual lumps or bumps on their breasts and men checking for abnormalities in the scrotal area. A full checkup with our doctor, or at the hospital, should be undertaken at least every 12 months.• Health Fitness Exercise is not only important for our heart, but it is also essential for maintaining a healthy weight and general well being. Not only can regular exercise half our chances of developing coronary heart disease and reduce our chances of having a stroke, but it also helps to lower blood pressure, reduce our chances of developing diabetes and can assist us to loose or maintain weight. In addition to the numerous health benefits of exercising, regular activity can also help to relieve stress, make us feel more energetic, help us to become more independent and lower our risk of osteoporosis. The great thing about exercise is that we will benefit from it as soon as we become more active. If we do not already exercise regularly, we need to start slowly and consider any health conditions that we have. Starting with a gentle form of exercise such as walking or swimming is a good way to build up our strength before taking up a sport or joining an exercise class. Even dancing, cycling to work, gardening or climbing the stairs is considered exercise. It is important to increase our activity gradually. Warm up before exercise and cool down after. If we experience any adverse symptoms when exercising, such as chest pain, it is important to consult our doctor, who will be able to advise on a safe level of activity for us. 12
  13. 13. Aerobic activities such as walking, cycling and swimming are the most suitable forms of exercise to start with. Avoid intense activities such as press-ups and weightlifting until one have achieved a reasonable level of fitness. Ideally one should exercise moderately for 30 minutes five days a week. It is possible to split one’s exercise into shorter sessions if you easily tire. An unhealthy lifestyle and physical inactivity can contribute to you gaining weight and can cause an increase in blood pressure. Regular exercise can reduce high blood pressure or prevent us from developing high blood pressure. Build more activity into our daily life and begin to see the benefits of regular exercise immediately.• Healthy Diet Opinions on healthy eating have changed greatly over the last half-century and in many Western countries what was previously considered a balanced diet is no longer considered such. Almost on a daily basis, science discovers new foods and edible substances that are deemed beneficial to health and longevity as well as the ill effects of foods previously deemed nutritionally sound. General consensus, however, dictates that a healthy diet should be low in saturated fats and high in fiber and that the number of calories we consume should be appropriate to our age, weight and level of daily activity. Beyond this, dietary specifics depend on the individual in question and any physical conditions or internal or external factors that might result in increased or decreased requirements for certain nutrients or compounds. “You are what you eat” is an old adage, but not one without credible foundation, with plenty of evidence to suggest that individuals who eat a balanced diet are far less likely to succumb to illness and disease than those who don’t. The amount of proteins, fats and carbohydrates we consume is appropriate to our individual physical requirements. 13
  14. 14. The above-mentioned compounds are commonly referred to as the three major food groups and nutritionists advise that for the purpose of good health, proteins should be a mix of animal and vegetable sources, fats consumed should be predominantly mono and polyunsaturated, and carbohydrates should be largely of the non-refined variety. Balance in diet can also refer to our intake of vitamins and minerals, and while certain circumstances such as pregnancy, illness or athletic activity can increase our need for specific nutrients, there are general guidelines for requirements. These guidelines are commonly known as Recommended Daily Allowances (RDA) and are devised using the needs of the average child, adult male and adult female as determining criteria. There are numerous other issues pertaining to a diet conducive to healthy living, with many individuals seeking the assistance of dietary supplements to address specific health requirements. Although some evidence exists to support the efficacy of certain supplements, nutritionists advise that such products should only be used in addition to and not as a substitute for a well-balanced diet• Healthy Skin While most of us enjoy a holiday at the beach and returning to the office with a deep, bronze tan as evidence of our dedicated hours in the tropical sun, the idea of a healthy tan has led us down a dangerous path. Although the sun provides us with necessary vitamin D, only an occasional 10 minutes of exposure is required. Prolonged exposure damages our skin, leading to wrinkles, discoloration and other blemishes while overexposure (sunburn) has been linked to sun poisoning, sun stroke, skin cancer and even death. Statistics show that in the United States, someone dies everyday due to melanoma. The detrimental effects of the sun are irreversible, so during next vacation to a sunny ski slope or a sandy beach keep the dangers of the sun in mind and take care of skin. 14
  15. 15. Fair-skinned people should avoid direct sunlight from 10:00 to 15:00 as a rule. Sunscreen should be applied at least 20 minutes prior to exposure and reapplied frequently. Sun block, on the other hand, provides instant protection and allows for immediate exposure. Either should be reapplied in accordance with the degree of perspiration or time in the water, regardless of whether or not the product is labeled as waterproof. UVA rays are the primary cause of premature aging, so wear a hat with a brim, loose-fitting clothing and sunglasses during those afternoon walks along the beach or while relaxing on the ski-lodge patio is recommended. The winter sun is just as dangerous as the summer sun and often more so due to the amplified reflection off the snow and ice. Remember too that overcast skies do not mean we are protected. Diffused rays can cause severe sunburn, even underwater. If returning from our holiday with milky white skin is a concern, consider that the medical expenses for the treatment of sun-induced disorders such as cold sores, eczema, wrinkles, loss of elasticity, sunburn and damage to the immune and vascular systems are far greater than the cost of a good hat, a pair of sunglass, a long-sleeved shirt and some sun block.• Healthy Sleep “Sleep, those little slices of death, how I loathe them”, wrote celebrated author of mystery and macabre, Edgar Allan Poe. If only Poe had realised the importance of sleep, he might have lived past his 40 short years. Indeed, evidence indicates that good sleeping habits can increase life expectancy. The science of sleep has been well studied and physicians have determined that a prerequisite of a healthy lifestyle is sufficient sleep to meet physical and mental needs. Though requirements vary according to factors such as age and level of activity, it’s generally accepted that eight hours (with a variance of an hour more or less) is a healthy period of time to spend at rest. 15
  16. 16. Though eight hours is considered an optimum period, there are many factors that can increase an individual’s need for sleep. Heavy exercise, illness, stress, depression and prolonged mental activity are among the most common circumstances. In such cases, nine or 10 hours may be considered more appropriate. Sleep is important for a variety of reasons and scientists have successfully broken its functions down into the following categories: restoration, preservation, memory processing, ontogenesis and anabolism. Though each of these areas can be explored in depth, in short, they refer to the processes required by all humans for unhindered mental and physical development and for the repair of any injuries sustained to either mind or body through disease or daily activity. Healthy rest depends on good sleeping habits and by this we mean going to bed and getting up at more or less the same times every day. In doing this, our internal body clocks become more finely tuned and we are not only able to fall asleep quicker, but we also benefit from more restful and productive periods of sleep. Avoiding stimulants such as caffeine, nicotine and theobromine (from chocolate) for at least four hours before bedtime is sensible if seeking restful sleep. Furthermore, drinking alcohol prior to sleep is inadvisable, as its effects tend to disrupt deep sleep patterns. Regular exercise can be useful in establishing healthy sleep routines; however, its best avoided two to three hours before bedtime as it encourages increased activity of the heart and nervous system, thereby becoming a hindrance to restful sleep.• Manage Stress Everyone feels stressed at one time or another, through work constraints, demanding relationships, health, and so on, and how we manage that stress is important for our overall wellbeing. 16
  17. 17. Stress can affect us in lots of ways, including: emotionally, throughanxiety or tension; behaviorally, through excessive smoking and drinking, beingoverweight, nervousness; and how we think, causing apathy, forgetfulness, andindecisiveness. If stress is not nipped in the bud fast, it can lead to all sorts of mental andeven physical illnesses. Immense pressure is placed on the body through how wethink, leading to an increase in heartbeat, breathing rate and blood pressure, andthe longer this goes on, the greater are the demands we place on our bodies. Common side effects from continued stress include cardiovascular disease(affecting heart and blood vessels), high blood pressure, and an acute proneness toinfection. Chronic fatigue is also common and can last for years if complete rest isnot initiated. As we can see, the way we think can have profound effects on ourwhole system. Luckily there are methods for managing stress and offices set up to help. Itis important to visit our doctor or community health center if we often feelstressed, anxious or depressed, and if we think we cannot deal with our reactionsto stress. Psychologists and counselors are specialists trained to deal with stress inindividuals. There are also basic things we can for our self to help cope with andmanage stress. One of the most important aspects for starters is to make sure weare well nourished and drink plenty of water, as lack of one or both can bring onor exacerbate stress in itself. Maintaining a certain level of fitness is alsofundamental in dealing with stress for similar reasons to being undernourished. In addition, we should also try to understand situations that make us feelstressed and try to avoid them; be it people, events or places. Also understandwhat situations are within our control, prepare ourselves for stressful events bythinking about the future and do things that make us happy. 17
  18. 18. • Stop Smoking There is no question that smoking is bad for us, as well as for those around us. Smoking is addictive primarily through the nicotine content (an alkaloid poison) in the tobacco, but also through the appeal of cigarette in-hand for many users. And it’s not all nicotine either; there are numerous other chemicals being inhaled which have profound affects on the body. In short, dozens of cancer- causing chemicals come with tobacco smoke, harming almost all organs in the body that ultimately leads to disease and lack of health in general. Common side affects from smoking include: coughing and wheezing; irritation of the windpipe and voice box; breathlessness; lung irritation and damage. Common diseases caused by long-term smoking include: lung cancer; lung diseases like chronic bronchitis; heart attack and stroke; gangrene through bad blood circulation. Specific negative attributes from smoking in the male body may include impotency and sperm complications, while females may experience reduced fertility, early menopause and increased risk of cancer of the cervix. The good news is that the earlier we quit the better chance we have of reducing our risk of major health complications, such as heart disease, stroke, and cancer. Those who manage to quit by the age of 30 gain a considerable number of years of life expectancy by avoiding many smoking-related diseases. Even those who quit at advanced years can improve their life expectancy. The affects on our health will not be immediate, but after a few months of quitting our heart and lungs will function better. Quitting smoking can be extremely difficult for many smokers who are addicted to nicotine and many people may need extra support when trying to go ‘cold turkey’. Telephone support and quitting smoking courses can help smokers kick the habit, while nicotine replacement therapy is available from pharmacies. 18
  19. 19. These include nicotine skin patches and nicotine impregnated lozenges, chewing gum, tablets and inhalers. Tips for quitting smoking: set a stop date and go cold turkey; discard all cigarettes, lighters and ashtrays; ask our smoking partner to also give it up, or at least be away from us when they want to smoke; ask for support from friends and family; take up regular exercise; eat more fruit, vegetables and less fatty foods if we gain weight; and treat ourselves with the money we save on cigarettes.• Substance Abuse There are different definitions of the term substance abuse, but for the layman it is best defined as the use of substances with psychoactive or stimulating properties in manners likely to cause harm to the physical or the mental health of the individual concerned. Substance abuse can lead to serious long-term problems and even death, depending on the circumstances and factors involved. The most obvious example of substance abuse is the abuse of alcohol, a phenomenon common to all societies where alcohol is legally available for consumption. Abuse to the point of addiction is termed ‘alcoholism’ and the most common long-term effect is cirrhosis of the liver, a condition frequently resulting in death. Alcoholism invariably impacts significantly on the families of sufferers. Since the effects to the health of long-term users are well-documented, tobacco smoking can also be considered substance abuse. Smokers experience withdrawal if deprived of nicotine in the short-term and risk complications such as emphysema, lung cancer, respiratory complaints and arterial disease if the habit is pursued over extended periods. The use of illegal drugs such as marijuana, amphetamines, cocaine and heroine may all be considered substance abuse since none are without side effects or the potential for damaging health. Though the dangers involved are specific to each drug and some carry considerably more serious risks than others, the common factor between all is that of dependency. Users can develop physical or mental addictions to these illegal substances. 19
  20. 20. Common household substances such as solvents and adhesives, gas and aerosols, paint and lighter fluid can also be addictive. Inhaling these substances brings the risk of damage to the heart, kidneys, brain, liver and other organs, as well as the possibility of Sudden Sniffing Death Syndrome. Many countries offer help for substance abusers; this can come in the form of government-funded projects or private assistance such as is available at rehabilitation centers and retreats at popular medical tourism destinations. Many hospitals have programs dedicated to assisting abusers, not only in their withdrawal from substances but also in the treatment of maladies brought on by them.• Weight Loss If we’re overweight, there are many reasons to lose some of the excess. Healthy weight loss can result in better general health, looking better, feeling better and increased levels of energy. Many people can lose weight but often struggle to keep the weight off once they’ve lost it. When we decide that we want to lose weight, it’s important to start the process with clear intentions and long- term goals. It’s good to start the weight loss process by having a clear idea of how much weight we need or want to lose. To help guide us with this we can ask our health-care provider to conduct a Body Mass Index (BMI) assessment. The assessment will give us a reliable measure of our total body fat by comparing our height and our weight. We can also make this assessment ourselves by using an online BMI calculator. The results of the BMI will place us in one of five categories, from underweight to extreme obesity. Once we’ve established our current weight category, we have to set ourself achievable and realistic goals. It’s better to spread your weight loss goals over a significant period of time rather than going for a quick weight loss program where we will be more prone to regaining weight after we have achieved our initial goal. Start by setting ourselves the goal of losing just a few pounds, then once we’ve achieved that goal, apply a second goal of keeping it off for one or two weeks. 20
  21. 21. Diet is one of the most important aspects of losing weight and keeping itoff. Try not to be taken in by fast track diets; while these types of diet may workin the short term, keeping the weight off can be difficult once we get bored of theimposed restrictions of the diet. Instead, start from working with our current dietand eating patterns. For one or two weeks, keep a record of what we eat and drink each day. Behonest and note quantity and portion sizes. Once we have a clear record of whatwe are eating and what our eating patterns are, then make realistic goals based onour records. If we see that we are eating a chocolate bar once every second day,make a goal to reduce this to a frequency that is achievable. Finally, keep active! Exercise and general activity is vital in the process oflosing weight healthily and keeping it off. Again, set achievable goals that we canincrease as time goes on. We may want to start with something simple likewalking to pick the kids up from school rather than driving.Women HealthFor women to stay healthy there are a number of special issues they shouldconsider to avoid female-related illness and disease. With the increase in breastand cervical cancer cases, it’s particularly important for women to ensure that theyconduct regular self-examination of breasts and have regular cervical Pap testsBreast cancer is one of the most common forms of cancer in women. When breastcancer is discovered early and treated quickly, the possibility of curing the diseaseis much higher. It’s therefore essential for women’s health that all women conductmonthly self-examination in order to detect any early signs of the disease. If youshould discover anything unusual, pay a visit to your women’s health-careprovider who will advise you in undergoing further tests if necessary. 21
  22. 22. Cervical cancer is also a common form of cancer in women and like breast cancer,early detection of the disease can increase the possibility of cure. To check forcervical cancer, cells that may result in cervical cancer or other cervical relatedinfections, women should have their health-care provider conduct regular Paptests.How often these tests should be conducted depends of your age and whether yousuffer from any other medical conditions. Your doctor will advise you how oftenyou need to be tested and of any other necessary precautions women should taketo stay healthy. 22
  23. 23. 4. Health Spas and Massage - Health Tourism Massage has been used for centuries to relieve stress and treat a variety of healthconditions. Ancient civilizations from Rome and Japan to India incorporated massagetechniques into their medical treatment regimens. Today, most people are familiar withmassage as a luxury spa treatment, and many new techniques have been developed toappeal to an ever widening taste for exotic and effective wellness experiences. The term ‘massage’ is generally used to describe treatments that use pressure tomanipulate the body’s soft tissues. Target areas can include skin, muscles, ligaments,tendons, joints, and other connective tissue. In addition, some massage therapies targetlymph vessels and various organs of the body. The goal is to promote healing, supportwellness, relieve stress, and clear the mind of clutter. The massage practitioner may use hands, feet, fingers, elbows, forearms, ormassage aids during a treatment. Scented or unscented oil is often used while heatedstones are now used in one of today’s popular massages. Depending on the type ofmassage, clients are clothed or unclothed. If unclothed, towels or sheets are draped forprivacy and only the area being worked on is uncovered. Clients may be seated on amassage chair or lie on a massage table or a mat on the floor. 23
  24. 24. The types of massage most familiar in western cultures include Swedish, deeptissue and sports massage. Asian massage techniques include Ayurvedic, Thai, Shiatsuand reflexology. Beyond these traditional methods, there are many types of massage thatcombine techniques, incorporate stretches, or target specific trigger points. Medical massage is used increasingly for conditions such as breast cancer, sinusrelief, and temporarily reducing blood pressure. Other types of medical massage are usedto relieve pain. Massage therapists and practitioners are usually regulated by a governing agencyof the country where they practice. Because there is no single entity regulating massage, itis best to ask your practitioner about their qualifications and training, or ask to see alicense or certificate verifying their compliance with local regulations. Countries with Health Spas: Czech Republic, Estonia, France, Germany, Hungary,Italy, Japan, Mexico, New Zealand,Philippines, Poland, Romania, Singapore,Slovakia, Slovenia, Thailand, Vietnam, USA.India is also emerging as a new health tourismdestination. Kerala is world famous for itsAyurveda and Massage therapies. We willlater discuss scope of Health Tourism inHimachal Pradesh. 24
  25. 25. 5. India Health Spas While not as popular a spa destination as Asian counterpart Thailand, India is anup-and-coming spa destination that attracts thousands of spa-goers each year with itsunique treatments not found elsewhere. Specializing in yoga, ayurvedic therapies and massage, Indian spas offer exoticwellness treatments suited to treating a range of ailments as well as generally rejuvenatingthe body as a whole. The growing spa industry in India is centered in Kerala, but there arequality spa resorts in most major tourist destinations. Better known for their specialist treatments than for their luxuriousness, Indianspas are among the most affordable spas in the world and offer a range of services. Somespas are part of resort complexes that offer accommodation and introductions into age-oldpractices such as yoga, meditation and ayurveda. Popular health spa treatments in India include: ayurvedic massage, rejuvenationtherapy and water therapies as well as standard spa treatments found elsewhere, such asfacials, body wraps and exfoliation. Many patients come for the alleviation of healthconditions through the use of ayurvedic medicines and therapies by qualified physicians. Unlike spas in many other parts of the world, spas in India typically offer insighton how to achieve a healthy lifestyle that maintains balance and harmony throughcenturies-old traditional methods. Ayurveda, yoga and meditation are all useful tools thatIndian spa therapists use to assist patients in making healthy lifestyle changes. 25
  26. 26. The modernity of spas in India is variable, but most health spas catering toforeigners are well equipped with contemporary facilities and trained professionals. Manypeople complement their spa treatments in India with sightseeing or a break by the beachat a luxury resort. Not all spas in India are regulated, making it essential you research the spa youwish to visit before seeking treatment. Make sure you choose a therapist that hassignificant experience in their field before undergoing any major spa treatment or therapyin India. 26
  27. 27. 6. Types of Massages for Health Tourism • Acupressure massage A traditional Chinese medical practice, acupressure is a technique based on the belief that stimulation of certain points of the body can bring relief of medical symptoms and their root causes. The practice is similar to acupuncture, making use of meridians (channels along which the body’s life energy, or qi, flows) to encourage the body to heal itself without need of drugs or surgery. Acupressurists will diagnose a patient’s problem based on the description of their symptoms and with little in the way of a physical examination aside from checking the patient’s pulse. The patient’s condition is, in Chinese medical terms, related to interference in the natural flow of qi (pronounced chi) in a specific area of the body. An Acupressurist will attempt to address this interference by applying pressure to specific points along the meridians with the hands, elbows or tools. The points chosen may or may not be focused in the area where the patient’s symptoms are located. Acupressure can be used to relieve a wide selection of ailments and is commonly reported to be successful in aiding those wanting to lose weight or quit smoking. Many pharmacies sell acupressure wristbands designed to alleviate the symptoms of pregnancy nausea or travel sickness, suggesting that there is some mainstream acceptance of acupressure theory. There is no scientific evidence to show correlations between acupressure and health benefits. However, there is some acknowledgement within the medical community of its benefits, with local GPs and medical specialists often referring patients for acupressure treatment when conventional approaches have proved ineffective. 27
  28. 28. • Aromatherapy massage Popular among followers of alternative and complimentary medical approaches, the principles of aromatherapy are several millennia old. Historians believe that it was probably the Chinese who first developed the belief that ingesting the vapors of oils derived from certain plants and their fruit can be beneficial to both physical and mental health. Although often under scrutiny from the conventional medical community, aromatherapy is regularly practiced. The most common means of ingesting essential oils is by inhalation. Oils are diluted with water and placed in an oil burner, with a candle producing enough heat to cause the oil to evaporate. As the vapors permeate the air, their effects may be felt by anyone in close proximity. The alternative to this method is to add a small volume of essential oil to base oil such as sweet almond and then apply to the body through massage. This technique allows external ailments to be treated directly, as opposed to inhalation which is intended to have a more general and systemic effect. Oils can be used to treat a variety of complaints with inhalation said to aid headaches, symptoms of common colds, stress, anxiety, insomnia and digestive complaints. Topical application is allegedly efficacious in treating arthritis and rheumatism, skin rashes and infections, warts, insect bites and minor wounds. Some elements of aromatherapy have worked their way into mainstream culture and consumerism. Nowadays it’s not uncommon to see essential oils such as tea tree added to popular skin and hair care products. Lavender is widely acknowledged for its calming effects and is commonly added to bath oils, pillows and inhalers (aroma sticks). 28
  29. 29. • Cranio sacral massage Cranio sacral therapy, known as CST, is a type of gentle bodywork or therapy that targets the membranes and cerebrospinal fluids that surround and cushion the brain and spinal cord. CST therapists believe that when this fluid is blocked, an imbalance occurs and illness and injury can result. CST concentrates on the cranio-sacral system, which is made up of the soft tissue and bones of the cranium (head), the pelvis, and the spine. Spinal fluid that travels through this system can be restricted by trauma to the body such as a fall or an accident, or through tension brought on by stress or nervousness. A blockage in this system can cause muscle and joint strain, emotional disturbances, and impeded operation of the body’s organs and central nervous system. A variety of healthcare providers practice CST in the course of their treatments. Dentists, massage therapists, chiropractors, osteopaths, occupational therapists, and nurses may all use CST to establish harmony in the central nervous system and assist in healing. During a full CST session with a specialist in this therapy, the movement of the cerebrospinal fluid is assessed. While lying face up on a massage table, the therapist gently manipulates the bones of the skull, spine and pelvis as well as the soft tissues of these areas to release blockages. Depending on the severity of the condition, more than one treatment session may be scheduled over a period of time. CST is commonly used to treat migraine headaches, sinus problems, TMJ syndrome, fibromyalgia, mental stress, and neck and back pain to name just a few conditions. CST takes advantage of the body’s natural healing capabilities and is often used along with traditional massage to help the body regain balance. 29
  30. 30. • Endermologie The unsightly dimpling of the skin on thighs and stomachs, called cellulite, is an endless source of frustration for many adults. Even very fit people may have cellulite, and weight loss and liposuction do not always affect the appearance of cellulite. Endermologie, a non-surgical and non-invasive technique that reduces the appearance of cellulite, is one approach to combating cellulite. Endermologie was developed by French plastic surgeons and the technique is now patented in the United States and approved by the Food and Drug Administration (FDA). The technique uses rollers and suction to redistribute the top layer of skin and reduce the dimpling effect of cellulite. It does not remove the fat under the skin, as liposuction does, but rather treats the skin’s appearance. During an endermologie session, a small, motorized device with two adjustable rollers and suction is applied to the problem area. The skin is gently folded and unfolded under the continuous action of the rollers, creating movement in the deep tissues. As the subcutaneous fat layer thins, blood and lymphatic flows increase, which causes the excess fluid to be released. Endermologie is most effective on fit persons between the ages of 30 and 45. People who do not exercise regularly may see only temporary results, and people more than 30 pounds overweight will most likely see no results from the treatment. Typically, 14 to 28 sessions are required, with monthly treatments thereafter. For maximum benefit, drinking eight glasses of water every day is recommended and regular exercise will also extend the benefits of the treatments. In addition to treating the appearance of cellulite, endermologie has some significant health benefits. It improves circulation, stimulates collagen production, causes deep lymphatic drainage and can improve symptoms of fibromyalgia and chronic fatigue. This technique can also be used to soften burn scars and connective tissue. 30
  31. 31. • Hot stone massage This highly relaxing form of massage is known for its stress-reducing properties. The hardness of the heated stones means the therapist can apply deep pressure, making this a good form of therapy if you want to address a specific area. Although this form of massage has been around for centuries, it only recently became internationally popular when US massage therapist Mary Nelson introduced its current form in 1993. The water-heated basalt stones used in hot stone massage vary in size and weight with some as small as a walnut while others come in at over one kilogram. The heat level of the stones is closely monitored before they are used. Stones below 118°F can fail to relax the muscles while stones over 129°F can cause discomfort to the client. Heated stones are typically placed under the client with a sheet of fabric in between. Other heated stones are then used for massaging the client along their leg, torso and arm muscles with the help of oil. The process is repeated on both the front and back of the body. Cold stones are occasionally used towards the end of the session. As the stones can target specific areas with ease, with the added benefit of the relaxing effects of heat, hot stone massage is considered to be very mentally relaxing. The benefits may also include improved circulation and calming of the nervous system. It is necessary to choose a therapist who has been properly trained in this type of massage. 31
  32. 32. • Lymph drainage massage Manual lymphatic drainage (MLD) is a gentle massage technique that improves circulation of the lymph through the lymphatic system. The human body’s lymphatic system drains fluids, detoxifies and regenerates tissues and helps maintain a healthy immune system. A lymphatic system that functions at its best is critical to the bodys health and wellbeing. In the 1930s, Dr Emil Vodder and his wife Estrid began using MLD to treat chronic sinusitis and other disorders of the immune system. They developed a technique of gentle hand movements to cause lymph movement and introduced their method in Paris in 1936. This technique is now one of the primary tools used to manage lymph-edema, a condition where the lymphatic system is obstructed. When the lymphatic system is obstructed, toxins accumulate and physical ailments can result. Lymphatic drainage massage therapy stimulates and moves excess fluid away from swollen areas so that it can drain away. It combines slow, gentle pressure with soft pumping movements in the direction of the body’s lymph nodes. The massage therapist usually starts with the lymph nodes in the neck and moves down the body, then out to the limbs. This massage technique uses the pads of the fingers and thumbs and the palms of the hands. The increase and decrease of pressure creates a suction and pumping effect that mimics the body’s natural action. Cancer treatments such as radiation and surgery can cause the lymph system to become blocked. With breast cancer, this often occurs in the armpit. Nodes in the groin area or the pelvis can occur if cancer affects these areas. MLD is very helpful in relieving swelling and helping the immune system to recover. In addition to these serious situations, MLD can also improve the appearance and health of skin. 32
  33. 33. • Microdermabrasion Microdermabrasion is a recently developed skin care technique used as an alternative to face lifts, plastic surgery, chemical peels and Botox. It is effective in reducing fine lines, sun damage, age spots, wrinkles and acne scars. Even better, it stimulates the production of skin cells and collagen for healthier skin overall. In microdermabrasion, tiny grains are used to gently buff away the top layer of skin, or stratum corneum. The stratum corneum is composed of dead skin cells that protect new skin cells growing beneath it. This layer is also where wrinkle lines and blemishes reside, so removing this layer also removes these imperfections in the skin. When the stratum corneum is removed, the theory is that the body rushes to replace the lost skin cells with new, healthy ones. Microdermabrasion is performed in salons and clinics by trained technicians or dermatologists. At a clinic or salon, the technician or dermatologist uses a tool that sends out a stream of tiny crystals (aluminum oxide, sodium chloride or sodium bicarbonate) and collects the leftover dead skin cells and used crystals in the tool’s vacuum. Some newer tools use a diamond-tipped wand instead of a stream of particles. In the first hour after treatment, the skin may show mild redness and swelling that can last from an hour to several days. For men and women, microdermabrasion is most often used to improve skin on the face, chest, neck, arms and hands. This technique has virtually no side effects and gives the skin a fresh, healthy glow. It is effective on all skin colors and types and can be used for skin that is sensitive to chemical procedures. A milder version of microdermabrasion can also be performed at home with over the counter creams and lotions. 33
  34. 34. • Myofascial release Myofascial release therapy is a massage technique that reduces or eliminates pain and tensions in the connecting tissue (fascia) of the human body. Stress, injuries, overuse and poor posture can cause restrictions to fascia. Myofascial release therapy is directed at freeing these constrictions or blockages. Fascia is tightly woven tissue that covers and interweaves every part of the body including nerves, veins, muscles, and internal organs. This fascia is one continuous system that ties the entire body together without interruption. It provides support and structure, but is also flexible so that we can move and bend with ease. Damage or injury to fascia affects more than just the area directly affected, making healing damaged fascia important for the body’s overall health and wellbeing. The developers of myofascial release therapy have backgrounds in physical therapy, rolfing, and other types of neuromuscular therapies. During a session, the therapist gently stretches tissues along muscle fibers. The stretch is held until the tension is released and the tissue softens. Stretches may be held for up to several minutes. A single session may last up to an hour and several sessions may be held over a week or more, depending on the severity of the condition. Myofascial release therapy is also commonly used to treat back pain, shoulder pain, headaches, fibromyalgia, chronic fatigue syndrome, menstrual problems, incontinence, tennis or golfers elbow, shin splints, sprains, rheumatoid arthritis, muscle spasms, whiplash injuries and carpal tunnel syndrome. In addition, myofascial release can be used to treat children suffering from birth trauma, head injuries, cerebral palsy, and scoliosis. 34
  35. 35. • Prenatal/postnatal massage For thousands of years and across many cultures, massage has been and continues to be an integral part of easing a woman’s pregnancy, labor, delivery and recovery after birth. In western society, pregnancy massage is becoming one of the fastest growing massage therapies. Expectant mothers experience unique physical and emotional changes due to increased weight, shifting posture, and changing hormone levels. Physical discomfort ranges from muscular tension and headaches to pressure on knees. These changes can create both physical and mental stress. Too much stress can negatively affect the health of both the mother and the baby, resulting in a higher incidence of miscarriage, premature labor and other complications. Massage can help a woman before and after birth by reducing both anxiety and physical pain. Prenatal massage takes traditional massage techniques such as Swedish or a deep tissue massage and tailors them to address the issues and conditions that a pregnant woman faces. For example, more time is spent on easing low back and hip pain, swelling, nausea, constipation and heartburn. During the massage, a pregnant woman is nestled in pillows or specially designed cushions and lies on her side or in a semi-reclining position. During labor, massage strokes on the backs and legs have been shown to speed labor and reduce the instances of complications in labor. After the babys birth, massage therapy can help the body return to its pre-pregnancy state, alleviate pain, promote a renewed sense of body and self, and help maintain flexibility despite the physical stresses of infant care. For post-caesarean mothers, postnatal massage techniques can also reduce scar tissue and aid the healing of the incision and related soft tissue areas. Expectant mothers should check with their doctors before getting a massage. Prenatal massage may not be recommended if the mother has diabetes or high blood pressure. Information about medical condition and personal preferences should be shared with the massage therapist so the massage can be tailored to meet specific needs. 35
  36. 36. • Reflexology If the way to a man’s heart is through his stomach, then it should come as no surprise that the road to health and wellness may lie in the soles of the feet. Reflexology, also called ‘zone therapy,’ is based on the belief that the bottom of the foot is covered with points that correspond to the body’s systems and parts. Massaging these points can bring healing and wellness to the body and rebalance its energy flow. Practices relating to reflexology date back to the ancient civilizations of China, India and Egypt. However, the technique was first introduced to the West in the early 1900s by Dr William Fitzgerald, who called the technique ‘zone therapy.’ Eunice Ingham developed Fitzgerald’s theory further and in the 1930s, reflexology was born. Today, reflexology has been shown to be effective for back pain, sports injuries, digestive and stress-related disorders, migraines, infertility, arthritis, sleep disorders and hormonal imbalances. A trained reflexologist first questions a patient about their medical history and current health issues to better direct treatment. Feet are then soaked in water and herbs, and then the therapist locates specific points on the soles of the feet or sometimes palms of the hands. Fingers are used to stroke and apply pressure to these points and to crush small ‘crystals’ that are deposits of lactic acid that build up in the feet. These crystals are then reabsorbed into the body and eliminated by the lymphatic system. Sessions generally last one hour, but a course of sessions may be prescribed depending on the specific needs of the patient. Every person’s experience is unique to them, and the therapist relies on information from the patient about how they feel and what they experience during the treatment. Because reflexology stimulates the body’s own self-healing, patients may feel nauseous, lethargic or tearful as the body begins to heal itself. 36
  37. 37. • Salt glow One of the most popular spa treatments today is salt glow. Incorporating scented oils and therapeutic salts, this treatment stimulates the skin and exfoliates it, leaving the recipient of this luxurious treatment with a healthy glow. Salt glows are also known as ‘salt scrubs’ and ‘sea salt scrubs,’ but they are essentially all the same. Because the salt is combined with oil and some type of aromatic such as lavender or lemon, it also hydrates the skin. Treatments can vary slightly at different spas, and most spas combine a salt glow with other treatments such as body wraps, steam showers and massages. The salt glow treatment itself takes between 40 minutes to an hour. During this relaxing and invigorating treatment, clients lie unclothed on a massage table or special wet table with a sheet or towel draped for modesty. The therapist rubs a mixture of sea salt and oil over the skin, covering both front and back sides of the body. Because salt is somewhat abrasive and therapists may use different amounts of pressure, it is important to speak up if the pressure applied is too much, or to request more pressure if desired. Afterward, the salt mixture is rinsed off. If a wet table is used, the therapist may use a hand-held showerhead or moist towels to remove the mixture. Some wet tables incorporate an array of showerheads that spray over the body. Other spas may provide a convenient shower enclosure for rinsing off. Once all traces of salt are removed, other treatments follow, most often a body wraps or massage. If no other treatments follow, the therapist applies body lotion with massaging strokes, leaving the skin feeling soft and radiant. 37
  38. 38. • Shiatsu Shiatsu is a Japanese style of acupressure developed over 5,000 years ago. Shiatsu combines the principles of traditional Chinese medicine with those of acupuncture, but it is performed with finger pressure instead of needles. There are a number of acupressure techniques, and Shiatsu is the most well known of these. Shiatsu practitioners believe that our vital life force, ‘chi’, flows in connected channels, or meridians, throughout the body. An organs chi can be accessed at certain points along the meridian. Shiatsu systematically stimulates the body by pressing on specific points along these meridians. Finger pressure stimulates the nerves and tissues, influencing the flow of chi. Poor or blocked chi circulation causes disharmony in the body that may show up as pain, emotional stress, depression, fatigue and disease. Proper chi circulation along the meridians creates harmonious movement and balance throughout the body. Shiatsu stimulates the circulation and the flow of lymphatic fluid and the hormonal and immune systems, releases toxins and tensions from muscles, and acts on the autonomic nervous system, allowing deep relaxation and promoting the body’s natural healing power. During a Shiatsu treatment session, loose clothing is worn and no massage oil is used. Shiatsu uses a combination of pressure and assisted-stretching techniques, some of which are common to other therapies. Shiatsu is not recommended for people with heart disorders, multiple sclerosis or cancer. Shiatsu can promote a sense of well being, but it also has a number of temporary side effects resulting from the blockages being released. Patients may feel tired or emotional, or experience coughing, excess mucus or headaches, or other pains and aches after treatment. In general, any such effects are considered positive signs that the body is making an attempt to correct its own condition in a natural way. 38
  39. 39. • Sports massage / deep tissue massage Increasingly, athletes and trainers are embracing massage as an integral part of their athletic regimens. Massage can treat sore muscles, promote healing, maintain health, and perhaps give an edge to competitive athletes by increasing their range of motion and flexibility. Weekend warriors, gardeners, parents of small children, and others who use their bodies in strenuous activities are also discovering the benefits of sports massage. Muscles, tendons and soft tissues can become stiff and sore for a variety of reasons. These include over exercise, damage to tissue, a build up of waste products and muscle spasms caused by reduced blood flow. Trigger points, or stress points, are specific spots on a muscle or tendon that are painful when pressed. Trigger points may be caused by falling or being hit, or they can develop over time from stress and strain. Sports massage often incorporates deep tissue techniques to work a specific joint, muscle or muscle group. Deep tissue massage does just what its name suggests: it reaches the deeper layers of the soft tissue. The practitioner uses fingers, knuckles, elbows, opposing thumbs, the heel of a hand or foot, and the forearm to reach these tissues. Pressure is applied gently at first and then becomes stronger as the deeper tissues are reached. Very little lubricant is used since this type of massage doesn’t travel generally over the skin, but is more focused on specific points. Regular sports massage can reduce the chances of injury by preparing the body for exercise. It can also reduce the amount of recovery time between workouts, improve flexibility in muscles and joints, and make the body more efficient in processing nutrients and oxygen. 39
  40. 40. • Swedish massage Swedish massage is one of the most well known and popular massage techniques today. This full body treatment helps the body to cleanse itself of toxins, relieves muscle tension, reduces stress, improves circulation and promotes relaxation. It is often used for patients with stiff joints and is helpful in relieving pain for arthritis sufferers. Swedish massage was developed in the 1800s by Dutchman Georg Mezger and later popularized by Per Henrik Ling, a Swedish fencing master and gymnastics teacher. Different types of long, flowing strokes are used in Swedish massage, usually in the direction of the heart. The patient is undressed and draped for modesty and oil, cream or lotion is used to reduce friction against the skin. Swedish massage often begins with effleurage. These are long, gliding strokes meant to calm and relax the muscles. Petrissage are kneading strokes applied using the palm or finger tips to roll and compress muscle tissue. Tapotement is a rhythmic stroke applied with the heel of the hand or edge of the palm that stimulates muscles and helps relieve cramped muscles. Vibration, compression and friction strokes are also used to release tension and reach deep tendons and ligaments. Friction can also help to reduce the formation of scar tissue. Because the skin is the largest organ of the body, massaging it with these specific strokes can set up a chain reaction that affects all the body’s systems in a positive way. It affects the muscles, nerves, glands and circulation systems to promote wellbeing and good health. 40
  41. 41. • Thai massage During a Thai massage, the whole body is treated to kneading, manipulation, stretching, and very active involvement with the masseuse. The masseuse uses elbows, knees, hands and feet to apply the massage, providing both stimulation and relaxation. Thai massage shares with other Asian healing practices the concept of energy lines that run throughout the body. These are called ‘meridians’ in Chinese medicine, ‘nadis’ in Indian medicine, and ‘sen’ in Thai. Traditional Thai massage focuses on 10 points along the sen lines that contain important energy points. In the northern style of Thai massage there are a lot of stretching movements, while the southern style emphasizes acupressure. In Thai massage, the recipient wears loose clothing and lies on a mat on the floor. The massage practitioner leans on the recipients body using hands and usually straight forearms locked at the elbow to apply firm, rhythmic pressure. The practitioner sometimes uses legs and feet as well. Oil is not used in traditional Thai massage. A full Thai massage session typically lasts two hours and includes rhythmic pressing and stretching of the entire body. This may include pulling fingers, toes and ears; cracking knuckles; walking on the recipients back; and manipulating the recipient into yoga stretching poses. There is a standard procedure followed in Thai massage that is adjusted according to the length of time requested. Traditional Thai massage has been used for centuries to treat muscle and joint pain, cramps, numbness, loss of strength and function, allergies and emotional stress and tension. It is used now to help treat a wide variety of ailments that include headaches, insomnia, high blood pressure, sciatica, low back pain, diabetes, menstrual pain and more. 41
  42. 42. 7. Medical Tourism as a part of Health Tourism Medical tourism or ‘global healthcare’ as it’s increasingly called, involvestravelling to a foreign country for a medical procedure. This industry has been growingrapidly over recent years as more and more people seek faster or cheaper alternatives tothe healthcare offered in their own countries. Occasionally the medical procedure neededis urgent, but more often it is an elective treatment such as cosmetic surgery or dentalcare. The number of people seeking healthcare in foreign countries now runs in themillions each year. Most patients are Westerners attracted to the concept of qualitysurgical treatment for a fraction of the cost they would pay in their own countries. Afterreceiving the medical treatment, the patients take a relaxing recovery vacation in the samecountry. Often patients can pay for their surgery, flight and a week or two at a resort foras little as a quarter of what they would have paid back at home. Leading the medical tourism industry is India, with Thailand and Malaysia closebehind. India’s medical tourism industry grows around 30 per cent annually, thanks to anaggressive marketing plan that focuses on all-inclusive package tours. Thailand’s main institute is Bangkok’s renowned Bumrungrad Hospital, whichcombines luxurious accommodations with world-class treatment. Bumrungrad Hospitalclaims to treat more patients per year than any other facility in the world. MeanwhileMalaysia promotes its many neighboring tourist destinations to match competitive rates,internationally-trained doctors and excellent facilities. The medical tourism industry has emerged in response to the incredibly huge costsof having most surgical procedures performed in countries like the United States, Britain 42
  43. 43. and Japan. Without medical insurance, most Westerners have no chance of being able toafford treatment, and sometimes even with insurance the costs are much higher than thoseoffered by Asia’s medical centers. Medical tourism has become big business for thesecountries by offering realistic costs for patients. Besides the obvious economic benefits of having your knee replacement surgerydone in a place like India or Thailand, one can enjoy a well-deserved vacation afterwards.Depending on the nature of the medical procedure, patients can lounge on the beach orvisit the major tourist attractions of the country. If the treatment is more severe, medicaltourism hospitals such as Bumrungrad have accommodations that seem more like a 5-starhotel than a hospital ward. Popular elective medical services include knee or hip joint replacements, cardiacsurgery, cosmetic surgery and dental surgery. Patients in need of emergency proceduresare also attracted to this concept as the wait period for certain operations can take up to ayear or more in their own countries. Often they can have the procedure done immediatelyin another country. Medical tourism fills a valuable niche that is desperately needed in countries withbureaucratically flawed or unaffordable healthcare. This industry looks set to expand at ablistering pace over the next decade as more and more people begin to trust the qualityand see the advantages of having their surgery performed in developing countries. 43
  44. 44. 8. Risks of Medical Tourism Looking at medical tourism from an economic perspective makes it easy to seewhy this option is so appealing. Receiving quality, affordable healthcare frominternationally-trained doctors and surgeons in a relaxing resort atmosphere is a greatoption. But patients considering medical travel should be aware that it does carry a fewserious risks. The most common issue related to medical tourism is the quality of the medicalinstitution itself. It can be difficult to check the qualifications of the doctors,anesthesiologists and other specialized staff at medical facilities which are privately-owned and operated. This is particularly true with cosmetic surgeons, who almost alwayshave their own privately-run clinics. It is absolutely essential that any medical tourist thoroughly researches thehospital, clinic or institution where they are planning to have their procedure done. This isbest accomplished by scouring the internet, especially blog sites that provide firsthandexperiences and advice from others who have already completed the procedure. With a bitof research reputable hospitals and clinics are globally well-known and easy todistinguish from shady unqualified doctors. The protection laws in a country are rarely enforceable in other nations. Patientswho receive poor or damaging medical treatment usually have no legal recourse.Malpractice and negligence by either the individual doctor or the institution are veryrarely covered, leaving medical tourists left to fend for themselves. On other hand, it’s thelack of expensive malpractice insurance prevalent in the West that helps keep costs solow in these countries. The issue of follow-up care is another thing to carefully research and considerbefore choosing an institution for your medical care. Most medical tourism packagesprovide very little, if any, follow-up care after your operation. Once you return to yourhome country, any complications that arise will be more difficult to deal with. Again, thisis a particular concern with cosmetic surgery. 44
  45. 45. The recovery vacation period so heavily promoted by medical tourism packagescan also carry certain risks. Depending on the extent of the surgery, travelling soon afteran operation greatly increases the potential for complications. Long air flights increasethe chance of swelling, blood clots and infection. Even sunbathing on the beach willdarken the scars. The best solution here is to allow for plenty of time to recover in the countrywhere the medical procedure is done. Don’t assume you can really get out and about toomuch during this vacation period. Rest is what your body will need, so choose calm,relaxing destination for this vacation recovery period. The bottom line is that medical tourism isn’t a perfect, guaranteed option.Travelers will be out of their element both during and after the procedure, potentiallyadding stress to the situation. Post-care varies widely between facilities, so do a thoroughcheck and carefully weigh the advantages of cost versus safety when making thisimportant decision. Chances are, if you pick a reputable hospital or clinic you will have no problemswhatsoever. But as the medical tourism industry continues to grow at such a fast pace, theinevitable quacks will become more prevalent.9. Benefits of Medical Tourism As the technology, doctor training and standards of healthcare in developingcountries has vastly improved in recent years, more and more people are looking atmedical tourism as an attractive solution to their health problems. The popularity ofmedical tourism can be directly traced to the incredibly high costs of healthcare and longwait periods for some procedures in many countries. Medical tourism is not a new idea. Ancient Greek pilgrims used to travel to asmall town called Epidauria for treatment. This area was considered the sanctuary ofAsklepios, the god of healing, and probably the first medical tourism destination. Spatowns were also considered medical travel destinations, especially in 18th centuryEngland, where patients believed the healing waters of some areas could treat gout, 45
  46. 46. bronchitis and other conditions. Today, Asian countries such as India, Thailand andMalaysia are leading the way in the medical tourism industry. Medical tourists come from all over the world, but most are citizens of Westernnations such as the United States, Britain, Europe, the Middle East and Japan. The mostobvious benefit for medical tourists is the dramatic savings in cost. A coronary arterybypass at Thailand’s Bumrungrad Hospital costs around one-tenth of what it does in theUnited States. Even more mundane procedures such as extreme dental work can be afraction of the cost in countries such as Thailand. Another major benefit is the speed at which some surgical procedures can becompleted. The waiting period for a hip replacement in Britain, for example, can be up toa year or more. A patient can fly to India, Thailand, Malaysia or the Philippines and havethe procedure done almost immediately. Since most of the doctors and surgeons inmedical tourism destinations have been well-trained internationally, patients can expectquality healthcare at the reputable institutions. Insurance is another factor in the decision to choose a foreign country for amedical procedure. Some orthopedic operations, especially knee and hip replacements,are often not covered by health insurance. As a result, orthopedic surgery has emerged asone of the main treatments performed overseas due to the low cost and freedom to choosewhere to have the surgery performed. People who cannot afford health insurance simply have no choice but to travelabroad for an expensive medical procedure. With an estimated 45 million Americanscurrently uninsured, this creates a huge market for people needing affordable healthcare. A final benefit is the pleasure of adding some travel and adventure to yourmedical needs. For many medical tourists, a trip to Thailand or India will be a first. A bigcomponent of the medical tourism industry is the relaxing vacation period following themedical procedure. Medical tourism destinations promote this aspect just as much as thequality and cost of their healthcare. In Thailand, patients can lounge on one of thecountry’s many beautiful beaches during their recovery, while India offers some amazingspa resorts where luxury and pampering is the focus. Up-and-coming South Africa evenpromotes wildlife safaris as part of its medical tourism packages. 46
  47. 47. 10. Medical Tourism in India Popular For: Alternative Medicine, bone-marrow transplant, cardiac bypass, eye surgery, hip replacement Visa Requirements: A valid passport and visa are required.India is a global leader in medical tourism, and one of the world’s least expensive choicesamong medical tourism destinations. Focusing on heart surgery, India also attractspatients with high quality dental care, Ayurvedic spa treatments and other medical andalternative treatments.Medical facilities at India’s leading private hospitals are excellent and state-of-the-art.Despite the country’s reputation for poverty and poor hygiene, the value for moneyoffered here draws thousands of patients each year. Many visitors complement treatmentswith a stay at an ashram where they can learn how to meditate or practice yoga fromexperts in these ancient traditions.Pros: The medical cost savings of having operations and treatments in India are amongthe best in the world, with fees between a third and 10 percent of the equivalent procedurein the US. Many doctors are trained abroad and hospitals attracting international patientsare on a par with those in the west with all staff being proficient in English. In addition,India has many appealing options for recovery with costs for accommodation typicallylow. The Indian health and medical industry is large and boasts some well developedinfrastructure, particularly in big cities such as Chennai, which support the wealthyclasses.Cons: Although India has a rich legacy of cultural sites that attract tourists, it is notpractical to enjoy some of these sites while recovering. If anyone do venture out of asterile hospital environment expect to be exposed to bacteria that may cause a stomachupset or worse. India gets extremely hot in the summer months, with temperaturesreaching 40°C at times. During the monsoons, water-borne diseases become a problemtoo, so choosing a good time to visit is essential. 47
  48. 48. 11. Alternative Medicine Treatments • Acupressure A traditional Chinese medical practice, acupressure is a technique based on the belief that stimulation of certain points of the body can bring relief of medical symptoms and their root causes. The practice is similar to acupuncture, making use of meridians (channels along which the body’s life energy, or qi, flows) to encourage the body to heal itself without need of drugs or surgery. Acupressurists will diagnose a patient’s problem based on the description of their symptoms and with little in the way of a physical examination aside from checking the patient’s pulse. The patient’s condition is, in Chinese medical terms, related to interference in the natural flow of qi (pronounced chi) in a specific area of the body. An acupressurist will attempt to address this interference by applying pressure to specific points along the meridians with the hands, elbows or tools. The points chosen may or may not be focused in the area where the patient’s symptoms are located. Acupressure can be used to relieve a wide selection of ailments and is commonly reported to be successful in aiding those wanting to lose weight or quit smoking. Many pharmacies sell acupressure wristbands designed to alleviate the symptoms of pregnancy nausea or travel sickness, suggesting that there is some mainstream acceptance of acupressure theory. There is no scientific evidence to show correlations between acupressure and health benefits. However, there is some acknowledgement within the medical community of its benefits, with local GPs and medical specialists often referring patients for acupressure treatment when conventional approaches have proved ineffective. 48
  49. 49. • Acupuncture Acupuncture is a Chinese practice based on the principles of Chinese medicine. The basis of the practice is the premise that the insertion of needles into specific points in the body can bring relief and even the cure the patient of physical ailments or disease. While there is no scientific evidence to back up the benefits of acupuncture, many doctors acknowledge that the practice may be capable of aiding patients who have not experienced any success with the use of conventional drugs or medical techniques. Acupuncturists believe that a person’s medical condition and their consequent symptoms are the result of a disturbance in the flow of qi (pronounced chi and meaning ‘life energy’) in some area of the body. In order to address the disturbance, practitioners insert needles into key point along meridians, which are the channels that Chinese medicine believes are responsible for moving qi around the body. A patient may have pain or symptoms in a specific area of the body. However, the acupuncturist may diagnose the root cause of the problem as being located elsewhere and consequently needles are often inserted into areas other than those where pain or visible maladies are present. The technique involves little in the way of pain or discomfort although it can be time consuming, sometimes requiring patients to endure lengthy periods with needles in their body. Acupuncture can be used as a single approach to a medical condition but is often combined with other elements of Chinese medicine for maximum effect. In western countries, the practice has gained popularity among patients wishing to lose weight or stop smoking. Irrespective of the treatment’s efficacy, it’s widely accepted that acupuncture is safe and presents few side effects for those undergoing treatment. 49
  50. 50. • Aromatherapy Popular among followers of alternative and complimentary medical approaches, the principles of aromatherapy are several millennia old. Historians believe that it was probably the Chinese who first developed the belief that ingesting the vapors of oils derived from certain plants and their fruit can be beneficial to both physical and mental health. Although often under scrutiny from the conventional medical community, aromatherapy is regularly practiced. The most common means of ingesting essential oils is by inhalation. Oils are diluted with water and placed in an oil burner, with a candle producing enough heat to cause the oil to evaporate. As the vapors permeate the air, their effects may be felt by anyone in close proximity. The alternative to this method is to add a small volume of essential oil to base oil such as sweet almond and then apply to the body through massage. This technique allows external ailments to be treated directly, as opposed to inhalation which is intended to have a more general and systemic effect. Oils can be used to treat a variety of complaints with inhalation said to aid headaches, symptoms of common colds, stress, anxiety, insomnia and digestive complaints. Topical application is allegedly efficacious in treating arthritis and rheumatism, skin rashes and infections, warts, insect bites and minor wounds. Some elements of aromatherapy have worked their way into mainstream culture and consumerism. Nowadays it’s not uncommon to see essential oils such as tea tree added to popular skin and hair care products. Lavender is widely acknowledged for its calming effects and is commonly added to bath oils, pillows and inhalers (aroma sticks). 50
  51. 51. • Ayurveda Also referred to as Ayurvedic medicine, Ayurveda (meaning ‘knowledge of life’) is an alternative medical approach that originated in India. It’s uncertain what period of history the philosophy was conceived, but historians speculate that it’s probably several thousand years old in its simplest form. Ayurveda is a holistic medical approach that considers both body and mind and their relationship to each other when diagnosing and treating a patient. The philosophy holds that we are all comprised of three essential abstract elements or properties, which Ayurveda refers to as doshas. The three doshas are: vata, pitta and kapha, and the degree to which each presides in us may determine our physical and mental characteristics. Ayurveda views disease and physical ailments as imbalances in the three doshas, or the tridosha system as it is otherwise known. Treatment is therefore a means of rebalancing the system and reestablishing harmony in the body. The philosophy holds that this can be achieved through various techniques which include the consumption of Ayurvedic herbs, the administration of special forms of massage, the adaptation of a specific diet, the practice of yoga and regular exposure to certain elements of nature. Having long been popular in Asia, Ayurveda is becoming increasingly popular in the west. Ayurvedic practitioners can assist with specialized treatments, but patients need to be aware of the specifics of their own tridosha system and the elements of their lifestyle that can aggravate it, in order to ensure that further imbalances are not created. The philosophies of Ayurvedic medicine have no scientific basis however many Ayurvedic treatments are unquestionably profoundly soothing and relaxing. The methods of purifying the body known as panchakarma are widely acknowledged as having obvious therapeutic properties including improved circulation; relief from pain, stress and insomnia; increased flexibility and improved athletic performance. 51
  52. 52. • Balneotherapy Balneotherapy is an approach to the treatment of disease or physical ailment involving bathing and stimulation of the body by water. The philosophy takes into account the chemical properties of specific sources of water as well as the effects of hot, cold and moving water. The name of the treatment is derived from the Latin word ‘balneum’ meaning ‘bath.’ Balneotherapy can be administered at a variety of locations. However, it’s often pushed commercially by spas which are strategically constructed at natural sources of water that are rich enough in therapeutic elements such as silica, sulfur, selenium, radium, arsenic, lithium, potassium, manganese, bromine and iodine to be beneficial to those who bathe in them. Due to a surge in popularity of spas, balneotherapy has come to mean almost any treatment that involves water including the consumption of water and the inhalation of vapors from waters rich in constituents deemed beneficial to health. The application of mud and sand to the skin is also often classified as balneotherapy. Ingredients used to good effect in balneotherapy are not necessarily found naturally in the water, with herbs such as chamomile, thyme, oak bark and walnut leaves commonly added to warm waters to address specific medical conditions. Balneotherapy is considered an alternative medical practice with little specific scientific evidence to substantiate its benefits. However, there are few conventional doctors that deny the physical and mental health benefits of bathing. As far back as Roman times bathing was recognized for its healing properties and this reputation has ensured that the practice has survived until modern times. Today the affluent enjoy balneotherapy as a spa treatment while those with circulatory, muscular and skeletal complaints among other ailments benefit from the symptomatic relief it provides. 52